BULACAN STATE UNIVERSITY

City of Malolos, Bulacan

OFFICE OF THE STUDENT FINANCIAL ASSISTANCE
AND SCHOLARSHIPS
Tel.# (044) 919780099 local 1086/ (044) 7906520
bulsuscholarships@yahoo.com

APPLICATION FORM
PICTURE
2x2
Scholarship Category/Specification

1st Semester SY 2022- 2023

Student Number: 2020400034 Date: September 24,2022

PERSONAL DATA

Name: Celestial Arianne Claire M. _Age: 21 Course/Yr./Sec. BEED 3A

(Surname) (First Name) (Middle) major: General Education

Campus: () Main Campus (√ ) Satellite: Meneses Campus

Place of Birth: Quezon City Citizenship: Filipino
Date of Birth September 1, 2001 Civil Status Single

Permanent Address 1105 Lungos St. Santa Ana Bulakan Bulacan Contact No.09386054765

Father: Arnel Noel Celestial Occupation: _Tricycle Driver Monthly Income: Less than 3,000
per month

If retired, year of retirement ____________If with pension, amount of pension____________

Mother: Nenita Celestial Occupation _Food dispatcher Monthly Income: 2500 per month_
If retired, year of retirement __________If with pension, Amount_______________________

If both parents are unemployed, state reasons/s

(E.g. retired, old age, health, etc. source of livelihood) ________________________________
(or contributions from other sources like relatives, etc.) _______________________________

If self-employed, state type of business ____________Earnings per year P ________________

Guardian Arnel Noel Celestial Occupation: Tricycle driver Salary Less than 3,000 per month
Relation Father

(If applicant is employed)

Occupation _____________Salary ________

(If applicant is married)

Name of Husband/Wife ______________ Occupation _______________Salary ____________

Name of Children Age

__________________________________________ _________________
__________________________________________ _________________

BulSU-OP-OSFAS-01F1
Revision: 0
(For unmarried applicant only)

Names of Brother and Sister Age Civil Status If working, state income/If student, state year level

Alysa Lynn M. Celestial 18 Single Incoming 1st year college

Angel Anne Mae M. Celestial 17 Single Grade 12

Subjects taken in the Immediate Units Grade

Preceding Semester

TCW 101 The Contemporary World 3 1.00

Educ 205 Assessnent of Learning 1 3 1.75

Educ 206 The Teacher and the Community,

School Culture and Organizational Leadership 3 1.00

GEd 204 Pagtuturo ng Filipino sa Elementarya

(Estruktura at Gamit ng Wikang Filipino 3 1.50

GEd 205 Teaching Science in the Intermediate

Grades (Physics, Earth and Space Science) 3 1.50

GEd 206 Teaching Social Studies in the

Intermediate Grades (Culture and Geography) 3 1.00

GEd 207 Teaching Arts in the Elementary Grades 3 1.00

PE 13 Physical Education 4 2 1.00

Total No. of Units 23.0 GPA 1.220

Other information:
1. Are you enjoying any scholarship or financial assistance, in the University? Yes ( )
No (√ ). Outside the University? Yes ( ) No (√ )

If the answer is “yes” to either or both, specify nature and amount of grant
or salary:

2. Do your parents: (a) own real properties? Yes ( ) No (√ )

If yes, specify: __________________________Market Value ______________

Others: (ex. cars, stocks, etc.) Market value: ___________________

I hereby certify that all the statements above are true and correct.

ARIANNE CLAIRE M. CELESTIAL

SIGNATURE OVER PRINTED NAME

Recommending Approval:
MS. JANE KRISTINE G. SUAREZ ASSOC PROF. JOSEPH ROY F. CELESTINO
Head, OSFAS Vice Chancellor for Student Affairs and Services

APPROVED:

DR. CECILIA N. GASCON

President